By George A. Cioffi, MD
This part underwent significant revision for the 2008-2009 edition.Topics mentioned contain the epidemiologic facets of glaucoma; hereditary and genetic components; intraocular strain and aqueous humor dynamics; medical review; clinical administration of and surgical remedy for glaucoma. This version includes up to date tables and revised pictures, in addition to quite a few new pictures illustrating either disorder entities and surgical recommendations.
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Additional resources for 2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009)
One such technology 30 . Glaucoma is the dynamic contour tonometer (DCT), a nonapplanation contact tonometer that may be more independent of corneal biomechanical properties and thickness than are older tonometers. Noncontact (air-puff) tonometers measure lOP without touching the eye, by measuring the time necessary for a given force of air to flatten a given area of the cornea. Readings obtained with these instruments vary widely, and lOP is often overestimated with these instruments. The instruments are often used in large-scale glaucoma-screening programs or by nonmedical health care providers.
All grading systems facilitate standardized description of angle structures and abbreviate that description. Keep in mind that, with abbreviated descriptions, some details of the angle structure will be eliminated. The most commonly used gonioscopic grading systems are the Shaffer and Spaeth systems. A quadrant-by-quadrant narrative description of the chamber angle noting localized findings such as neovascular tufts, angle recession, or PAS may also be used to document serial gonioscopic findings.
Gonioscopy Gonioscopy is an essential diagnostic tool and examination technique used to visualize the structures of the anterior chamber angle. Mastering the various techniques of gonioscopy is crucial in the evaluation of glaucoma patients. Figures 3-1 and 3-2 give schematic and clinical views of the angle as seen with gonioscopy. Gonioscopy is required to visualize the chamber angle because under normal conditions light reflected from the angle structures undergoes total internal reflection at the tear-air interface.
2008-2009 Basic and Clinical Science Course: Section 10: Glaucoma (Basic and Clinical Science Course 2008-2009) by George A. Cioffi, MD